Foreign Granulomas

Testes from the males examined 43 days after the 8-D treatment appeared normal. However, the epididymis was involved in an inflammatory process with sperm granulomas formation. The granulomatous epididymal lesion resembled the lesion seen in auto-immune reaction following bacterial infections or tissue response to foreign bodies (16, 17,... 

Lubricant laxatives. Liquid paraffin (paraffinum subliquidum) is almost nonabsorbable and makes feces softer and more easily passed. It interferes with the absorption of fat-soluble vitamins by trapping them. The few absorbed paraffin particles may induce formation of foreign-body granulomas in enteric lymph nodes (paraffinomas). Aspiration into the bronchial tract can result in lipoid pneumonia. Because of these adverse effects, its use is not advisable. 

In both cases, pneumothorax occurred with a delay after cocaine inhalation. The authors suggested that it was therefore unlikely that these cases of pneumothorax were due to direct traumatic effects of the drug powder inhaled, to barotrauma due to exaggerated inspiration, or to a Valsalva maneuver. Histological examination in both cases showed small foreign body granulomas with polarized material in the subpleural parenchyma. The authors proposed that the pleural damage could have been directly caused by a filler substance known as mannite (a fine white powder comprised of insoluble cellulose fibers). 

An exudative granulomatous reaction started 2 days after the injection of hyaluronic acid (Hylaform) (dose not stated) for perioral wrinkles (7). The eczematous papular skin changes disappeared completely within 6 weeks, and could be provoked by intracutaneous testing with Hylaform (dose not stated). Histological examination showed a foreign body granuloma. 

A 60-year-old woman receiving interferon alfa developed cutaneous sarcoid foreign body granulomas at the sites of a previously childhood skin injury (356). 

This suggests that interferon alfa may facilitate the development of cutaneous sarcoid granuloma from particulate foreign matter. 

Eberlein-Konig B, Hein R, Abeck D, Engst R, Ring J. Cutaneous sarcoid foreign body granulomas developing in sites of previous skin injury after systemic interferon-alpha treatment for chronic hepatitis C. Br J Dermatol 1999 140(2) 370-2. 

Foreign body giant cell granulomas were first reported after liquid silicone injection in 1965 (14) and are usually observed near siUcone-injected areas (15). There have been many reports of cysts and granulomatous reactions to silicone at application sites and distal sites after hematogenous or lymphatic migration (15-17). 

Johnson DC, Petru A, Azimi PH. Foreign body pulmonary granulomas in an abuser of nasally inhaled drugs. Pediatrics 1991 88 159-161. 

The USP specifies that injectable products be 100% inspected to ensure that the product is free from visible foreign particulate matter (< 788>). This is crucial because particulate matter in injectable drug products is considered a clinical hazard. Particulate matter has been implicated in the formation of granulomas in various internal organs in rats, as well as embolisms and phlebitis in humans.4 Pulmonary capillaries (the smallest capillary vessels in the human body) are about 7 (tm in size. This is why determination of particles about 7 Lm and larger is deemed important. 

These materials have a very good biocompatibility, in addition to an inert and bioactive behavior. The main problem with these carbon materials is their easy wear, which results in the release of black, sharp-edged particles. This may induce either a tattoo effect or the frequent appearance of granuloma as a foreign body reaction with inflammatory cells. This reaction is neither chemical nor physiological, but is a physical and mechanical effect (Oppenheimer effect). The problem has been resolved by the addition of epoxy resins to harden the carbon... 

Fig. 1 Foreign body granuloma. Small PLGA debris (black arrows) broken off from tbe PLGA film, surrounded by macrophages and multinucleated giant cells (white arrows). These induced macrophages and multinucleated giant cells were remaining over 2 months.

Foreign substances penetrating the skin may induce granulomas (see Chap. 15 by Pigatto). 

In the hamster, multiple short-term intratracheal instillations of zirconium lactate produced lesions beginning with exudative pneumonia followed by pneumonitis (interstitial pneumonia) and foreign body granulomas. Electron microscope microprobe analysis demonstrated the metallic component of the instilled compound in membrane-bound cytoplasmic inclusions of macrophages (Leininger et al. 1977). 

In a female aged 50 years working in a plant manufacturing nuclear fuel rods for 17 years, sarcoid-like pulmonary granulomas showed epithehoid cells and multinucleated foreign body giant cells interpreted as a zirconitun pneumoconiosis (Kotter and ZiEGER 1992). 

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